I have often posted on the topic of the lessons the dying can teach us. I think it is something we need to listen to and to contemplate. Here is one doctor’s take on the subject from her own experiences.

As for me, back when I was a hospice physician making house calls to care for the dying patients on our service I never dreamed that I would one day write a book about that experience. I didn’t know that my own life would be profoundly changed by listening to the stories of those patients and learning from them the lessons that were being revealed as they drew closer and closer to death. But that is exactly what happened.

One day a patient named Ted told me that he had only just begun to understand “what really matters” in life. He bemoaned the fact that he couldn’t pass along that wisdom to anyone else because he would be gone from this life in a few weeks. So I made a promise that day to remember Ted’s story and share it with others.

From that point on I began to recognize that many of my dying patients seemed to be learning lessons in their final days that totally changed the way they looked at life. For Ted the lesson was Love: he came to see that Love was far more important than all the wealth, status and possessions he had accumulated during his lifetime. For Greg, a young man dying of malignant melanoma, the lesson was Forgiveness as he reunited with his estranged brothers and all three of them healed years of pain and anger during the last weeks of Greg’s life.

At first I saw these lessons as a step-by-step guide for how to approach death and I shared them with other dying patients who were struggling to make sense of what was happening to them. But eventually I realized that the way I lived my own life each day was being transformed by the stories I was gathering. That’s when it dawned on me that these were really the lessons of living and they could be learned at any time during life, not just in the final days.

Over the remaining years of my hospice career many other patients came with stories that added to my understanding of “what really matters.” I learned to live in the Present Moment from Ralph, a previously homeless alcoholic who discovered a talent for drawing pictures after being told he would soon die of kidney cancer. And from Andy, who lost half his face to cancer, I was shown how to surrender to whatever difficulties life brings along the way.

As the story of my own life unfolded over time I was given opportunities to not only learn but to actually live each one of these lessons that I had been taught — all in preparation for one day writing about them in “What Really Matters.” But the biggest awakening came when I met Lorraine, a writer herself who was dying of breast cancer. She had been a spiritual seeker all her life who had already been living “what really matters” for many years. Lorraine showed me the paradox that death itself is the path to life and that mortality is our greatest gift.

In an instant my mind was blown open and my vision expanded to the largest view possible: the more fully I accept my death, the more fully I will be alive. When I no longer fear my death then I will no longer fear my life. Suddenly I could see everything through new eyes. Death was teaching me a state of fearlessness that allowed me to move forward in areas of my life where I had been stuck and stagnant before.

As I contemplate the dire condition of our world today with its global financial meltdown, environmental degradation, political unrest, crippling poverty and crumbling infrastructure I recognize that fearlessness is the only thing that can help us move forward through these crises. We must be fearless in order to make the best choices for the future, to stand up to hatred and to rid ourselves of outmoded biases and institutions that no longer serve our growth.

When time and energy are at a premium they must not be squandered on anything other than what really matters. The time has arrived for each of us to set aside our foolish and petty grievances and allow our false illusions to fall apart so that something new can emerge and grow. All the disasters on this planet are arising simultaneously with perfect timing to bring us to this point of transformation. If death has taught us anything let it be that we cannot wait; the time for change is now.

Life has a way of leading us to unexpected places.

In my case, life led me to death and back again with a powerful knowledge of what really matters. And that has changed everything for me.

Where is life leading you and what changes are you willing to allow? Answer that question carefully, for it is the change that takes place in you that will bring about the change the world needs in order to survive. Let your fearlessness guide your choices.

At the start of Yom Kippur, we recite the communal nullification of vows, Kol Nidrei. We ask the heavenly tribunal to release us from anything we have may purposefully or inadvertently vowed to do or to refrain from doing. It is difficult to understand why we need to go through this ceremonial annulment as we begin Yom Kippur. For those who have recited Hatarat Nedarim, the nullification of vows, as is customary to do before Rosh Hashanah, this seems to be superfluous. Besides, do we really mean that anything we ever say that might be construed as being an oath should be nullified, even for things we have yet to say?

Speech is a very slippery thing. We know how easy it is for us to slip into saying things we come to regret later. We don’t mean to say something obnoxious to others. We don’t mean to start things that seem impossible to complete. How do we see our speech as we begin Yom Kippur?

To start, we have to realize the severity of vow-taking. In the book of Genesis, when Jacob takes leave of his father in law Laban, we have an exchange of dire consequences. Laban accuses Jacob of having stolen his idols. Jacob denies these allegations and then says (30:32) that if the idols are found amongst his family, then that person will no longer live. The verse concludes by saying that Jacob didn’t know that it was Rachel who stole them. While Laban never finds out it is Rachel, we are told later that Rachel’s dying in childbirth was a direct result of this vow taken by Jacob. If Jacob would have known that Rachel had taken the idols, he would not have said such harsh words.

In the modern work, Bilvavi Mishkan Evneh, R. Itamar Schwartz explains how speech is the physical manifestation of the divine in the world. Speech is the conduit for the soul to interact with the physical world. He further discusses how speech is a way of expressing what is truly in our hearts. This he derives from the idea that the soul emerges from the world of truth, and as such is unable to express itself in any other way than through what it sees as true.

When we talk about humanity, the Biblical commentators define complex speech as the symbol of what makes human’s divine in relation to other living creatures. Yom Kippur is the culmination of this distinction. It is on Yom Kippur that we purify ourselves through prayer, that we are able to recite the words Baruch Shem Kavod Malchuto L’Olam Va’ed (blessed is the Glorious Name, His Kingship should rule forever) in a loud, audible voice. The rabbis describe humanity as angelic on Yom Kippur, as we rise to the ultimate manifestation of divinity for the 25 hr. period. As such, there is no more fitting way to begin the fast day than to focus in our speech.

We ask the heavenly tribunal to recognize that through our physical imperfections, our speech often comes out in ways we, our soul, would not want to be shared. Our primary goal for the next 25 hours is to be cognizant of our prayers, recognizing in ourselves how sincere we really are. We need to strive for sincere prayer, one in which as we confess our sins gives us a sense of growth. May we have a meaningful Yom Kippur, one in which we strive to allow our soul to express itself from the world of truth, and with the power of Yom Kippur, may our high carry through the remainder of the holidays and throughout the rest of the year.

Everything that is born, dies. We acknowledge our mortality, but should we give it much thought? The Spanish philosopher de Unamuno wrote that the syllogism that used to be taught in logic classes: Socrates is a man; all men are mortal; therefore Socrates is mortal, sounds very different when rendered: I am a man; all men are mortal; therefore I will die.

For Unamuno, as for all existentialist thinkers, death is the great, unavoidable question. From death flows the urgency and responsibility of life.

Not every thinker agrees. Spinoza wrote that a wise man thinks of nothing less than death. Spinoza spun his ideas from the eternal stratosphere of reason and logic. He believed that philosophy, like logic, mathematics and reason, all transcend accidents of birth and death.

Yom Kippur is a powerful existentialist statement. In its best known prayer, the Unetaneh Tokef, we are reminded that we are fleeting, that our lives are like the wind that blows, like the flower that fades, as a passing shadow. On Yom Kippur we dress in white. It has connotations of purity, because white shows the slightest stain. But the deeper reason is that a robe is reminiscent of the shrouds in which we will be buried. We emulate corpses: not eating, not drinking, freed of the body. This will one day be our fate.

With deep psychological acuity, Freud’s words spring from just this tradition: “We recall the old proverb, if you want to preserve peace, arm for war. Well, if you want to endure life, prepare for death.” Yom Kippur, when we remove ourselves form the world for a day, reminds us that one day the world will get along without us. We prepare for death to more powerfully return to life.

The daily whisper of mortality grows to a roar on this holiest day. While we pray to be granted one more year we look around the synagogue. Some who were there last year, for many years past, are no longer with us. The empty seat or the new occupant brings the shock of unpleasant recognition: One day, each person knows, she or he will be that missing worshiper.

Judaism asks us to grasp both ends: We know we will die, and therefore should savor all that life offers. Our time is given vividness and urgency by being limited. Love is more precious knowing the sun will set.

One of the most famous Rabbis of the last century was Rabbi Israel Kagan, known as the “Chofetz Chaim” (literally, the one who desires life, so named for his works on proper speech, after the phrase in Psalm 34:12). One day a group of tourists from America, traveling in Eastern Europe, went to visit the famous Chofetz Chaim in his town of Radun. When they came to see him they saw the world famous Rabbi in a small study with a rickety desk and a few books.

One of the incredulous tourists said, “Rabbi, where is all your stuff?”

The Chofetz Chaim smiled, “Where is all yours?”

“But” the man answered, “we are just passing through.”

The Chofetz Chaim nodded, “Me too.”
To live with an awareness of death is to live in gratitude for the realization that we are passing through. At moments it feels like we have forever. Yet we know it is not so. Yom Kippur arrives to remind us that time is limited. We beat our chests, the Jewish defibrillation, to revive our hearts, to awaken ourselves to our own swift passage. Today, though, on this day, it is our privilege to be alive. Let us repent, renew and live the time we are lucky to have with vividness, brio, goodness and in gratitude to God.

Forgiveness is only one part of a larger process of working through a painful event, trauma, or loss, and it generally comes at the tail end of that process, after a lot of work has been done. As I explained in the previous post, it’s a choice not an obligation. When our hurts have been many and encountered over a lifetime, it sometimes takes years to get to forgiveness. There are no rules. Each of us must come to the decision about whether or not to forgive for ourselves and in our own time–much to the dismay and worry of our friends and family.

Consider the reasons why you might choose to forgive someone who did you wrong. Forgiveness is usually accompanied by a lifting of depression and anxiety and an increase in physical health and well-being. Forgiveness also brings a lessening of suffering and offers a newfound peace that helps you go on with life.

What is forgiveness, exactly?

In the effort to define and describe forgiveness, researchers have differentiated between “decisional forgiveness” and “emotional forgiveness.” Decisional forgiveness is having the thought or intention to stop an unforgiving stance and to respond differently towards the person who hurt you. Emotional forgiveness is actually replacing negative unforgiving emotions with positive more empathic emotions.

Most of us start with the desire to forgive someone (the decision) and then go through the emotional work to finally let go. It’s a two part process. The first step is the decision to let go of resentment and thoughts of revenge. The second step, once completed, brings newfound feelings of understanding, empathy and compassion for the one who hurt you. (Reminder: You can forgive the person while still condemning the act.)

What are the Steps to Forgiveness?

1. It helps to begin by recognizing the value of forgiveness and its importance in your life. Imagine how you will feel without the bitter feelings you’ve been carrying around. Make a list of all the advantages of letting go versus holding on.

2. Reflect on the facts of the situation and how you reacted, and how this combination has affected your life, health and well-being. Write a letter to the person or people who have hurt you. Write it for yourself so you can be excruciatingly open and honest about how you feel. Write about it as much as you need to, for as long as you need to. Stop in the middle if you need to cry about what you are writing. Notice how the letter changes each time you write it. Eventually, you may choose to share your letter with the person who hurt you.

3. Allow yourself to feel without judging yourself. You will most likely (depending on the size of the trauma) have to cry buckets of tears, shake with fear, and scream in rage to let go of all the feelings inside. (If expression of feelings is difficult–if you can’t express them or if you are exploding all over the place, please check out books and blogs on this topic first.)

4. If the pain is too much to handle alone, you may want to talk with someone who is wise and compassionate, such as a spiritual leader, a mental health provider, or an unbiased family member or friend. Just knowing that others have faced similar challenges can make you feel less isolated. You don’t need to go it alone.

5. The process often involves forgiving yourself as well. Write a letter expressing compassion and love for yourself, describing what you have learned. Reflecting on times you’ve hurt others and on those who’ve forgiven you may help you if you get stuck.

6. Think about the expectations you have of others. Are you expecting too much or too little? Since we cannot change anyone but ourselves, as much as we’d like to, try to put your energy into setting positive goals for the future. Instead of mentally replaying tapes of your past traumas, seek out and practice new ways to get what you want.

7. Remember that living a good life is proof to others that no one can rob you of your humanity. Your courageous act of forgiveness will give you back your power.When you focus on your wounded feelings, you continue to give the person who caused you pain power over you.

8. When you’re ready, actively choose to forgive the person who’s offended you. This is often strengthened through creating a ritual. Go to a sacred space in nature and burn the letter that described the pain you suffered. Say out loud “I forgive you.”

9. Usually there’s a gift that has come through your wound–things like learning to have more empathy for others, discovering a renewed commitment to help those in pain, or feeling more gratitude for the good things in life and the friends who have supported you. Find a symbol of your gift and carry it with you or paint it or keep it on your bedside table.

10. Find some way to celebrate yourself when you complete your journey to set yourself free from your past. Throw a party, light a candle, jump in the ocean, plant a seedling–even howl at the moon. You’ve arrived to yourself and to the present moment. Yes.

In the midst of the High Holiday liturgy, Jews around the world recite a prayer that describes the imagery of all of humanity passing before G-d in judgment. In describing Judgment Day, the prayer states; “The great shofar is sounded, and a silent, still voice is heard.”

The blowing of the shofar, the act of crying out to G-d through the use of an animal’s horn, is described as a wake-up call. We are to arise and open our eyes to be more conscious of the world and of ourselves.

The sound of a shofar is the primal cry of all humanity, mimicking the different cries experienced during loss. Yet, we are simultaneously tasked, as the stanza indicates, to also hear the silent, still voice.

What is this silence, and how does hearing the silence between the sounds of crying enhance our growth as human beings?

Life today is very noisy. We are constantly inundated with the wonder of instant communication and technology. While there is tremendous value in having everything at our fingertips, we have lost the ability to hear the silence.

In “Ethics of Our Fathers,” a work of ethical and moral statements of the rabbis of old, Rabbi Shimon ben Gamliel taught: “All my days I grew up around sages. I found that there is nothing better for the body than silence; explanation is not the essential feature, rather action; and all who speak too much will come to sin” (Chapter 1:17).

One explanation offered reads this piece as a unified, single subject. One should limit what one says about material, this-worldly subjects. Additionally, one should not be so cavalier as to think speaking about spiritual matters is a simple task as well. One should be just as careful about discussing spiritual matters because words become meaningless and fleeting when there is nothing concretizing one’s thought. Finally, if one does speak more and doesn’t perform, one will bring about negative judgment towards everyone. In other words, Rabban Shimon ben Gamliel is describing a contemplative quiet; a person needs to learn the value of choosing the appropriate moments to speak.

Silence also has another function, specifically for this time of year, the aseret yemei teshuvah. R. Nachman of Breslov explains that to truly repent, one must listen and remain silent.[2] This is represented by the bracha on teqiat shofar, lishmoa’ kol shofar, on hearing the sound of the shofar. The mitzvah of Shofar is to listen. But what are we listening to? What is the sound of the shofar?

We are listening to a seemingly paradoxical sound. In the world of Tanach, the shofar communicated pomp and circumstance, its sound conveyed national energy. Its sounds would accompany the most meaningful, most sweeping public moments – the blasts of the shofar would accompany the coronation of the King, the army marching proudly into battle, the declaration of the Jubilee year. Yet Hazal, in their interpretations, hear the sound of weeping in the shofar as well – the cries of an abandoned child in distress, rachel mevakha al baneha and the cries of a mother waiting for her son to return home from war, eim Sisera, from whom we learn the tradition of the 100 blasts we sound. There is no paradox, no contradiction between these two experiences. The teqiyot, the triumphant, unbroken sounds, represent us at our most complete and whole, the triumphant, the happy. The shevarim and teruot, the broken blasts, represent those moments when we are broken, when all we can do is cry. Taken together, the sounds of the shofar represent the extremes of the human experience – from the proudest moments to the meekest, from the communal to the solitary. The moments when we feel like saying, as Rabbi Soloveitchik did in his famous essay, Lonely Man of Faith:

I am lonely. Let me emphasize, however, that by stating “I am lonely” I do not intend to convey to you the impression that I am alone. I, thank G-d, do enjoy the love and friendship of many. I meet people, talk, preach, argue, reason: I am surrounded by comrades and acquaintances. And yet, companionship and friendship do not alleviate the passional experience of loneliness which trails me constantly. I am lonely because at times I feel rejected and thrust away by everybody, not excluding my most intimate friends, and the words of the Psalmist, “My father and my mother have forsaken me” ring quite often in my ears like the plaintive cooing of the turtledove.[3]

The shofar gives voice to those moments that are expressed by pure emotion, the moments when we have so much say, but have no words.

After each blast of the shofar, there is a moment of silence. Unetaneh Tokef describes the experience of the revelation of the Shechina on Rosh Hashanah. We chant “uvashofar gadol yitaqah, v’qol dememah daqqa yishamah – and the great shofar is sounded, and a silent, still voice is heard.” After each blast of the shofar, after expressing our most personal prayers and innermost thoughts, if we listened carefully, we could hear that silent, still voice – we could hear God whispering back. We encounter God through the transcendent moments in our lives, at the happiest times and at the saddest times, when we are alone in our thoughts and prayers, when there are no words, because nothing more needs to be said.[4]

The still, small voice of Rosh Hashanah is about hearing the echoes of life. Whether we laugh or cry, those sounds are the overt expression of our emotions. The challenge is to hear those same sounds when we are afraid of being expressive. When sitting in synagogue, reading the different pieces of liturgy, are we hearing our thoughts as well? Do we understand the words we are reading and what they say about life? Have we given ourselves time to be internally reflective? Do we hear the cries of the others around us? Or are we scared of the inner voice, so we do all we can to drown it out?

As we reflect on the sounds we are about to hear, I would like to take this opportunity to wish that this be a year we hear the quiet between the tears, the silence between the laughter, and allow that silence to be a guide for a sweet and meaningful new year.

As we begin look forward to the new Jewish calendar year of 5773, I feel an overwhelming sense of ‘now what?’ We gather every year on Rosh Hashanah and pray to G-d. We begin the ten day process of penance that culminates in Y”K. Yet, what are we doing? Can we possibly stand in judgment before G-d? I recall some years ago standing on Y”K, reciting the Al cheits, clopping my chest with my fist, and I began laughing inside. I felt as though standing in G-d’s presence and confessing sins must be the ultimate cosmic joke. Yet, here we stand again, on judgment day, proclaiming G-d as King and hoping that we are written for good.

When we enter Rosh Hashanah, we have high hopes, even in the midst of the challenges around us. We hope this will be a better year. But what can we really say before G-d? To answer this question, I would like to look at three descriptions of prayer in the Bible as seen through the eyes of the rabbis of old, Chazal, for through this exploration we can have a deeper sense of the grandeur of prayer.

G-d tells Abraham that the plan is to destroy Sodom and Gomorrah and the other outlying cities due to their wickedness. G-d offers this warning to Abraham because G-d feels that Abraham, as the eventual “owner” of the land, should know what will happen to some of his territory. When Abraham hears about the destruction, he doesn’t just let it happen. Rather, he tries to bargain with G-d, asking Him to spare the cities even for 10 righteous people in these 5 cities. And while the prayers ultimately did not save these cities (though probably helped in sparing his nephew Lot and his two daughters), the story is recorded to show how humanity should approach G-d. We should be strong enough to bargain but also recognize the limitations of compromise.

The book of Deuteronomy begins with the verse, “these are the words that Moses spoke in…” giving us a long geographic description. Rashi, the great medieval commentator, explains that the list was really a veiled attempt at chastisement. Instead of fleshing out what happened, Moses merely mentioned places or descriptive titles to describe the sins of the people in the desert. One of the terms, Dei Zahav, the place of Gold, refers to the building of the Golden calf. Rashi quotes from the Talmud in tractate Berachot, which says that these words actually reflect a conversation between Moses and G-d. Moses tells G-d, ‘it is Your fault the people made the Golden Calf because you gave them all that gold and silver.’ Moses, in pleading with G-d to save the people from destruction, resorts to blaming G-d for the faults of humanity.

The third biblical reference is from the beginning of the book of Samuel, describing Hannah, Samuel’s mother, as she prays for G-d to give her a son. The fourth chapter of BT Tractate Berakhot describes how we learn about prayer from Hannah. In the midst of this discussion, which extrapolates lessons from the description of how she prays, including how why the Rosh Hashanah Mussaf service contains two extra sections, the Talmud (31b) teaches us a very difficult monologue. The Talmud records an embellished prayer of Hannah’s. She turns to G-d and says:

Dear G-d, you are the Master of the Universe. If it suites You to provide me a child, good. If not, then I will have no choice but to force your hand. I will seclude myself with other men, forcing my husband to have to bring me to the Tabernacle (in Shilo as the Temple was not yet in existence), where I will have to drink the waters of the suspected adulteress. At that point, my innocence will be proven, and as You have promised, the innocent woman will be fertile. Only then will I have a child.

When I came across these words, I began to tremble. How could such a righteous woman, one of the prophetesses, have the audacity to speak so harshly to G-d? Could any of us imagine doing the same? The same can be said for the first two stories as well. Can one imagine bargaining or critiquing G-d if we knew G-d would actually respond back?

For most, Rosh Hashanah revolves around the blowing of the Shofar. The Shofar represents Abraham having the strength to withstand G-d’s ultimate test, which we read on the second day of Rosh Hashanah. In the merit of Abraham not arguing with G-d, we blow the shofar, representing the ram that Abraham sacrifices instead of Isaac.

Yet, as we stand on Rosh Hashanah, year in and year out, praying and hoping for a sweet year, we run into a problem. Just like the people of Israel in the desert, whom Moses defended by saying that G-d caused the sin because of the excess of riches, we too could make the same claim. Why is it we don’t turn to G-d and argue:

Dear G-d. We are here again standing in your shadow. We are in your presence. We are unworthy, because we are full of sin. But you know what G-d, it’s your fault we sinned. You are the master of the world. You created us with good and evil. You created the evil inclination, the yetzer hara. Therefore, we are blameless because without that stumbling block, we wouldn’t be in need of judgment each year.

Could any of us imagine saying such a thing? And yet, the rabbis of 2000 years ago put those similar words into Moses’ mouth. As an aside, the Talmud also shares a story about how after the destruction of the first Temple, the people begged G-d to remove the evil inclination from their midst so as not to fall into the trap of idolatry. And G-d obliged. While this led to a society free of sin and blemish, this also had an untold consequence. Men and women no longer showed interest in each other, thus not fulfilling the basic human element of procreation, which as we shared before, is such a basic instinct that a woman as great as Hannah would sin in order to become fertile. So G-d reinstated the Yetzer Hara, thus putting us back into the same predicament.

What is the message of these three areas of confronting G-d, bargaining, critiquing and threatening, and how can we relate this to the moment, standing before Shofar blowing and Mussaf?

The answer lies in a fundamental aspect of belief. If we truly believe in the idea of Avinu Malkeinu, our Father our King, then we would be more willing to be audacious in prayer. When we request something from another, we assume the other is in a position of strength because they can grant or deny our request. Yet, unlike the general request, we look to G-d not just as the one in power. We also see the softer side, Avinu, the parent. When a child wants from a parent, they will resort to almost anything to get it, as all of you recall, either as the child or the parent. When we stand on Rosh Hashanah, do we feel that we can talk to G-d as a child before the parent, ready to say almost anything to get what we want? This is the lesson of the bible and the rabbis. Prayer is twofold, recognizing the true power and also recognizing that true power being merciful and willing to give if prodded. As we cry through the primal sound of the shofar and prayer the special mussaf, may we merit the strength and ability to approach G-d and cajole and argue for a year filled with good, a year filled with life and find the ultimate of forgiveness again during these 10 days of penance.

In the midst of the High Holiday liturgy, Jews around the world recite a prayer that describes the imagery of all of humanity passing before G-d in judgment. In describing Judgment Day, the prayer states; “The great shofar is sounded, and a silent, still voice is heard.”

The blowing of the shofar, the act of crying out to G-d through the use of an animal’s horn, is described as a wake-up call. We are to arise and open our eyes to be more conscious of the world and of ourselves.

The sound of a shofar is the primal cry of all humanity, mimicking the different cries experienced during loss. Yet, we are simultaneously tasked, as the stanza indicates, to also hear the silent, still voice.

What is this silence, and how does hearing the silence between the sounds of crying enhance our growth as human beings?

Life today is very noisy. We are constantly inundated with the wonder of instant communication and technology. While there is tremendous value in having everything at our fingertips, we have lost the ability to hear the silence.

In “Ethics of Our Fathers,” a work of ethical and moral statements of the rabbis of old, Rabbi Shimon ben Gamliel taught: “All my days I grew up around sages. I found that there is nothing better for the body than silence; explanation is not the essential feature, rather action; and all who speak too much will come to sin” (Chapter 1:17).

One explanation offered reads this piece as a unified, single subject. One should limit what one says about material, this-worldly subjects. Additionally, one should not be so cavalier as to think speaking about spiritual matters is a simple task as well. One should be just as careful about discussing spiritual matters because words become meaningless and fleeting when there is nothing concretizing one’s thought. Finally, if one does speak more and doesn’t perform, one will bring about negative judgment towards everyone. In other words, Rabban Shimon ben Gamliel is describing a contemplative quiet; a person needs to learn the value of choosing the appropriate moments to speak.

The still, small voice of Rosh Hashanah is about hearing the echoes of life. Whether we laugh or cry, those sounds are the overt expression of our emotions. The challenge is to hear those same sounds when we are afraid of being expressive. When sitting in synagogue, reading the different pieces of liturgy, are we hearing our thoughts as well? Do we understand the words we are reading and what they say about life? Have we given ourselves time to be internally reflective? Do we hear the cries of the others around us? Or are we scared of the inner voice, so we do all we can to drown it out?

As we enter the Jewish New Year of 5773 on Sunday evening, may this be a year we hear the quiet between the tears, the silence between the laughter, and allow that silence to be a guide for a sweet and meaningful new year.

Rabbi Bryan Kinzbrunner is the campus chaplain for the Oscar and Ella Wilf Campus for Senior Living, which comprises the Martin and Edith Stein Assisted Living, the Lena and David T. Wilentz Senior Residence and the Martin and Edith Stein Hospice. For more information, call 888-311-5231 or visit www.wilfcampus.org.

One of the most difficult subjects in regards to suicide and suicidal ideation is the issue of whether one can try to have a loved one temporarily hospitalized as a means of preventing suicide in someone who is at potential risk. The challenge lies in various legal and ethical issues. In the below piece, one doctor offers his advice to those dealing with the question of hospitalization.

I was recently faced with the dilemma of whether or not my wife was a danger to herself and others, and whether or not to take her to the emergency room as a psychiatric emergency.

Are there any guidelines or suggestions as to when its best to take a loved one to the hospital?

Dr. Mark Komrad, M.D. responded:

This is one of the challenging issues in all of psychiatry — both practically and ethically. So I can only attempt to address it in a most preliminary fashion.

The easy answer is: call your wife’s psychiatrist. I believe that all physicians should have a system to be available in the case of possible emergency. That is a fundamental ethical principle we are taught in medical school. Every patient and family should be familiar with how to contact the psychiatrist in the case of emergency.

One of the most common reasons psychiatrists are reached in an emergency is to consult on just this situation — whether or not a person should go to an emergency room (ER). As a part of residence training, all psychiatrists have extensive experience with this scenario.

What if the doctor can’t be reached or if there is no psychiatrist on the case … yet? The primary concern is safety — hers and yours. If there is any question that your wife is unable to control her behavior to maintain safety, it is reason enough to have an evaluation in the ER. Safety includes considerations of violence to self and others, as well as other kinds of safety such as fire safety, fall risk, or medical risk.

A diabetic who is refusing to eat, a person with unstable hypertension who is highly agitated, a person who has fallen into an unmoving catatonia and isn’t acting to take care of his basic needs, a person who environment has deteriorated to a fire or health hazard: these are all examples of various cases from my own clinical experience that have been appropriately brought to the ER.

So, if the doctor says go — go. If you feel there is a risk of harm afoot — go.

A final consideration in your decision: if someone has never been in for treatment, an ER evaluation can open the door to mental health treatment, and is sometimes the only first step a person is willing to take.

I haven’t posted in a few days due to preparations for Rosh Hashanah next week. However, having been working with many recently around grief, I thought this piece would be appropriate to share with you.

If you learn nothing else about grief, you should consider these three truths that can change how you see grief, how you mourn and how heavy your burden of loss can become from this point on in your life. Grief is never easy but with knowledge–plus support, comfort and encouragement from others–grief can become easier.

1. Grief is a natural response to the death of someone you love or have an emotional investment in. This means:

Grief is not a disease, a mental or emotional disorder, a bad attitude or perspective, or a sin.

Your grief does not indicate there is anything wrong with you that must be fixed, cured, pitied, or corrected. You are okay. You are not going crazy.

Your grief experience indicates that you still have an overflowing love for a person who is no longer physically present. That overflowing love still needs to be expressed but in a new way since the person is physically absent from your life.

Grief is how you express that overflowing love for the person who died. Therefore, grief is another healthy expression of love.

As long as your grief progresses and does not hurt you or anyone else, mourning the death of your loved one is healthy and healing.

2. Grief allows you to recall and miss a valuable person who deserves to be remembered and honored. This means:

Grieving a valuable person who has died can be a privilege and joy. Therefore grief does not have to be an obnoxious obligation that must be tolerated.

Grief is not an emotional reaction that you would rather avoid. Your healthy grief is your continued expression of love for the person.

Grief gives the honor, respect and time your loved one deserves. Because of your grief and mourning your loved one will not be forgotten by others or you.

Grief allows you to continue a healthy spiritual and emotional relationship with the person who has died. You do not have to give them up, let go of them, or detach from them in order to continue your life. You can take their memory and what they gave you with you the rest of your life. Your loved one’s death did not end your relationship-it just changed the relationship by taking the person from your physical presence.

Grief has no timetable or time limitations. You can mourn and remember your loved one whenever the need arises in your life.

3. Grieving in a healthy way remembers, respects and honors a valuable life. This means:

As long as you need to remember and honor your loved one, you will miss them and express your love for them in your grief. Over time that grief will change. It will not always be as overwhelming and all-consuming as it is in the beginning. But as long as you miss your loved one, you will mourn their absence to some degree.

By the way you grieve and the way you live after the death you become a living memorial and legacy for your loved one. Your grief and your good life carry on their memory and influence. You can carry your loved one with you always.

Written by Larry M. Barber, LPC-S, CT, author of the grief survival guide “Love Never Dies: Embracing Grief with Hope and Promise” Available on http://grief-works.org/book.php. Also available on Amazon.com, Barnes & Noble, and your local bookstore. Available now for Nook and Kindle.

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A few weeks ago, someone wrote an article about his confrontation with the notion that we are all going to die. It is a very touching and deeply thought provoking piece. I specifically liked his statement that he had decided at one point in life that he wouldn’t die.

So it has come to this. I am going to die. I wish I could tell you otherwise. I wish I had something more positive to say. For a long time things were fine. I reassured myself: I will not die. I reassured others, not so much by what I said as by my general demeanour. Don’t worry, I always seemed to be telling them, Nothing to be alarmed about, I will not die.

I have been thinking about this since I was a few years old, only a boy. A woman who’d drifted into our home and moved in with us, a real brokenhearted bundle of nerves, ran over her cat one day in the driveway. The cat died. It lay there and wouldn’t get up. It wouldn’t play or drink milk or anything. It was dead.

My father explained it to me. He was delicate, careful with his words, almost apologetic when he explained it. Everything dies, that’s what he told me. He spread his hands in a gesture of helplessness. I could see the embarrassment in his face, as if this whole unseemly business of dying and being dead was somehow his fault. Forgive me, he seemed to be saying, The cat has died because all things die; forgive me.

After he had explained it to me, I gave it a great deal of consideration. I was even-handed about it, I weighed up the pros and cons as fairly as I could, but in the end I decided this sort of thing just isn’t for me. Dying – it’s fine for cats, it’s fine for other people (strangers especially), but it’s not the kind of thing for me.

So I decided I would not die.

Of course there is a lot to be said for dying, I know that. Think of the alternative. Consider the indignity of watching your own children and your children’s children entering the slow decline of a second infancy. Think of the endlessness of old age; the terrible strain on a diminishing circle of perpetual carers; the constant expansion of aged care facilities, until finally entire cities would be nothing more than gigantic under-staffed nursing homes, crowded with those who have lived forever but have forgotten their lives and even their names. Or even worse, imagine living forever without ever forgetting, tormented by wounds of regret for everything you ever said and did, so that everything hurts more acutely with every passing year, world without end.

Living forever is not all it’s cracked up to be, even as a boy I could see that. In the long run, it makes a great deal of sense for other people to die, for everyone to die. I wasn’t naive. I reconciled myself to the fact of death. Yet pondering all this at the age of three or four as I looked into the eyes of the small dead cat, I thought the universe ought to make an exception in my case.

And yet here I am, dying after all. How did it ever come to this?

I went to see a doctor and he gave it to me straight. It is my heart, that’s what he told me. Apparently I have a condition that makes my heart wear out after the first seven or eight decades of my life. Subtract from that a few years for every unhealthy lifestyle choice I’ve ever made along the way: smoking, drinking, not jogging, using real butter instead of margarine, too much salt, too much sugar, too much of the wrong sort of fat, not enough of the right sort of fat, too many of the wrong kinds of drugs, not enough of the right kinds, too much sitting in front of the television, not enough rest, not enough vegetables, too many non-organic vegetables with all those nasty carcinogens sprayed all over them, all subtracting year after year after year from an already perilously short life. Taking everything together, I’ll be lucky if I get another forty years out of this heart. Less than thirty if my grandfathers’ lousy tickers are anything to go by. Bloody genes, can’t live with them, can’t live without them.

If I knew what was good for me I’d be running around the block right now or lining up for a gym membership instead of squandering my remaining time sitting in a chair (subtract 4 years) having coffee (subtract 1.5) and a butter croissant (subtract 2) and writing down these dying words.

What should I tell you? What can I say for myself? What message should I leave you from beyond the grave? That I should have used margarine after all? That organic groceries are really worth the extra expense, when you factor death into the equation? Or maybe something more personal: ‘Dad, you were right about death. I forgive you.’ How would that sound?

No, death and dying notwithstanding, I guess all I’d really like to say is that I’m glad to have been alive. That alive is a very good thing to be, and I have not a single word to say against it. That I have loved songs and food and drink and night time and the way friends’ voices sound around a campfire in the dead of night. That I have loved animals, especially dogs and cats, and if I had ever got to know horses properly I would have loved them too. That I have seen whales, have witnessed their rolling bigness, and have loved them very much. That I have loved books and reading, have loved re-reading certain books and remembering what it was like to read them for the first time. That I have loved the faces of my friends (I hope somebody will remember those faces after I’m gone). That I have loved strangers’ faces too, old men and old women and beautiful women whose faces I fell in love with and never forgot even though I only saw them once, across a crowded room or in a train or on a bridge as I walked by. That I have loved my wife’s face and my wife’s words and my wife’s skin and the way my wife thinks when she is happy or when she is sad or when she is tired or first wakes up, wide awake and already hatching plans while I am still trying to dream. That I have loved my –

My children.

As I sit here now, as I sit dying, my heart slowly wearing out inside me, that is all I really want to tell you. I have loved all of it and I don’t have a word to say against it. To tell you the truth, I even love the things that I have hated. Doing wrong, being wronged, this whole miserable business of hurt and misunderstanding and mistakes. I have loved all that because I have loved forgiving and being forgiven. Yes, that’s what I have loved most of all. If I could do it all over again I would make all the same mistakes and let all the same mistakes happen to me too, if it only meant that I could have the chance, just once, to forgive, to be forgiven.

Life is very wonderful, and the meaning of it all is the forgiveness of sins, that’s what I’d like to tell you. I am glad to have learned that. I am glad to have been alive and to have made so many mistakes and to have borne the brunt of so many too. It is wonderful, all of it.

It is thirty years since the day my father explained death to me, since I looked into the wise dead eyes of the cat and understood. I’m trying, but I still haven’t reconciled myself to dying, not really. But when that faulty clock inside me stops ticking and there is no one about to wind it up again, I hope I will be able to die just as I have lived: forgiven.